高白细胞急性白血病去白细胞术的微循环观察

目的观察高白细胞性急性白血病(HyperleukocyticAcuteLeukemia,HLAL)去白细胞术前后的微循环学变化,指导HLAL的治疗。方法40例HLAL患者行去白细胞术,观测术前后的微循环学参数,应用t检验分析统计学差异。结果全部患者术后临床症状均完全缓解。4例DIC者1例痊愈,3例显效。甲襞微循环除管襻形态无明显改善外,血流形态、襻周状态及总积分值均有改善(P<0.01),而全部血流变学参数均显著降低(P<0.05)。结论去白细胞术既能迅速减轻肿瘤负荷,又能纠正患者微循环的异常,是HLAL的安全有效治疗方法。

A Microcirculartion Observation on Hyperleukocytic Acute Leukemia Patients Treated with Leukapheresis

Objective To observe the microcirculation changes on hyperleukocytic acute leukemia (HLAL) patients before and after leukapheresis(LP). Methods Forty HLAL patients were treated with LP, observe microcircular parameters before and after LP, analyse statistical difference by t test. Result All clinical symptoms were completely relieved in the patients. One patient was cured and three were obviously effective in four patients with DIC. Except that shape of vascular loop had no significant difference,the velocity of blood flow and the state around vessel and total integral value showed significant difference in nailfold microcirculartion parameters (P<0.01). All blood rheological parameters showed significant depression (P<0.05) . Conclusion LP could decrease the cancer load rapidly and correct abnormality in microcirculation, it is a safe and effective method for treatment of HLAL.